Emerging Technologies

I t is difficult to believe how much musculoskeletal medicine has improved over the past 30 years. In the sports medicine world, the arthroscope has been one of the instruments that has revolutionized orthopaedic care of the synovial joints, especially the knee, shoulder, and recently, the hip. These developments are far beyond what orthopaedic entrepreneurs of the 1970s and 1980s could imagine. Many orthopaedic residents today have not performed arthrotomies on many of these joints, which were the standard of care to treat even the simplest of joint disorders not long ago. I am thankful that I witnessed the transition from open joint surgery to endoscopic approaches as the arthroscope made its way from the hands of a few gifted orthopaedic surgeons to academic medical centers. Interestingly, many respected orthopaedic educators of the past did not welcome this transition to arthroscopy, which slowed its acceptance in academia. Along with an improved ability to treat joint disorders without the trauma of open joint surgery came the need for improved diagnostic capabilities of critical soft tissue components of synovial joints. These critical components included articular cartilage, the menisci and anterior cruciate ligament (ACL) in the knee, and the glenoid labrum and rotator cuff in the shoulder. This need was quickly filled with the development of magnetic resonance imaging (MRI) in the 1980s and its rapid incorporation into clinical medicine in the 1990s. Ultrasound was soon to follow, adding to the armamentarium of the musculoskeletal clinician. These diagnostic and treatment advances have greatly enhanced musculoskeletal care as the role of the orthopaedic surgeon advanced as a specialist in the medical community. Consequently, many medical students have been drawn to orthopaedics by these and other patient care enhancements, making orthopaedic surgery one of the more competitive resident education programs. Truthfully, I don't think that I'd be a competitive applicant these days. Fast forward to 2016 where continued diagnostic imaging advancements have improved not only clinical care but have also become important tools in the research of disease, trauma care, and preventive medicine. Examples of these features are highlighted in this issue of Sports Health. The review by Li et al 3 on " Advanced Imaging in Osteoarthritis " highlights the noninvasive, multiplanar capability, and excellent soft tissue contrast of today's MRI techniques. The quantitative and compositional evaluation of articular cartilage ultrastructure along with the diffusion and chemical exchange transfer technologies has made the monitoring …